3.5 Abuse of Disabled Children

Contents

• Vulnerability to abuse(Jump to)
• Indicators of possible abuse or neglect(Jump to)
• What this means for practice(Jump to)
• Assessment, support and treatment(Jump to)
• Disabled children and the law(Jump to)
• Further information(Jump to)

Vulnerability to abuse

Safeguarding disabled children’s welfare is everybody’s responsibility, and given that we know that disabled children are more vulnerable to abuse than non-disabled children, awareness amongst professionals about safeguarding disabled children and what constitutes best practice, is essential.

Disabled children may be especially vulnerable to abuse for a number of reasons. For example:

• Many disabled children are at an increased likelihood of being socially isolated with fewer outside contacts than non disabled children
• Their dependency on parents and carers for practical assistance in daily living, including intimate personal care, increases their risk of exposure to abusive behaviour
• They have an impaired capacity to resist or avoid abuse
• They may have speech, language and communication needs which may make it difficult to tell others what is happening
• They often do not have access to someone they can trust to disclose that they have been abused
• They are especially vulnerable to bullying and intimidation
• Looked after disabled children are not only vulnerable to the same factors that exist for all children living away from home, but are particularly susceptible to possible abuse because of their additional dependency on residential and hospital staff for day to day physical care needs.

For more information, see Safeguarding disabled children (Department for Education).

Indicators of possible abuse or neglect

When undertaking an assessment (and considering whether significant harm might be indicated) professionals should always take into account the nature of the child’s disability. The following are some indicators of possible abuse or neglect:

• A bruise in a site that might not be of concern on an ambulant child, such as the shin, might be of concern on a non-mobile child
• Not getting enough help with feeding leading to malnourishment
• Poor toileting arrangements
• Lack of stimulation
• Unjustified and/or excessive use of restraint
• Rough handling, extreme behaviour modification e.g. deprivation of liquid, medication, food or clothing
• Unwillingness to try to learn a child’s means of communication
• Ill-fitting equipment e.g. calipers, sleep boards, inappropriate splinting; misappropriation of a child’s finances
• Invasive procedures which are unnecessary or are carried out against the child’s will.

For more information, see Safeguarding disabled children (Department for Education).

What this means for practice

Disabled children are subject to the same procedures for initiating a strategy discussion, as non-disabled children. Where there are concerns about a child with disabilities a referral should be made in accordance with the Referrals Procedure.

When undertaking investigations/assessments into allegations of abuse concerning disabled children, practitioners need to take into account the following considerations:

• Whilst section 47 enquiries are being carried out, the first responsibility, as with any investigation into allegations of abuse and/or neglect is to ensure that the child is safe.
• Where there are abuse allegations relating to a disabled child the safeguarding needs of any siblings living in the family home also need to be considered.
• Where there are allegations of abuse and a disabled child is the alleged perpetrator, investigations need to be handled with particular sensitivity. A duty of care should be shown to both the victim and the alleged perpetrator.
• Any enquiries planned or undertaken should be carried out with sensitivity and an informed understanding of a disabled child’s needs and disability. This includes taking into consideration matters such as the venue for the interview/s; the care needs of the disabled child; whether additional equipment or facilities are required; who should conduct the interview and whether someone with specialist skills in the child’s preferred method of communication needs to be involved.
• As with all section 47 enquiries, the need for accurate, detailed, contemporaneous recording of information is essential.
• Throughout all discussions (including strategy discussions, section 47 enquiries/core assessments, the initial child protection conference and any subsequent child protection review conferences), all service providers must ensure that they communicate clearly with the disabled child and family, and with one another, as there is likely to be a greater number of professionals involved with a disabled child than with a non-disabled child.
• The disabled child’s preferred communication method for understanding and expressing themselves needs to be given the utmost priority, and where a child has speech, language and communication needs, including those with non verbal means of communication and deaf children, arrangements will need to be made to ensure that the child can communicate about any abuse or neglect she/he is experiencing and their views and feelings can be made obtained.
• Where the parents of a disabled child have a disability themselves, arrangements also need to be put in place to accommodate their needs throughout the investigation/assessment process.
• The number of carers involved with the child should be established as well as where the care is provided and when. A disabled child’s network of carers could include short break foster carers, volunteer befrienders, sitters, personal assistants, community support workers, residential care staff, independent visitors and learning support assistants.
• The collating of medical information concerning the health needs of the child is important as it may be have a bearing on the outcome of any enquiry/investigation.
• Where there is a need for a medical examination, consideration needs to be given to the most appropriate medical professional who should undertake the examination, the venue, timing and the child’s ability to understand the purpose of the medical procedure.
• Where there is to be a police investigation into allegations of abuse or neglect of a disabled child, those undertaking such investigations should not make presumptions about the ability of the child to give credible evidence. All such investigations should be undertaken in accordance with the practice guidance Achieving Best Evidence in Criminal Proceedings: Guidance on vulnerable or intimidated witnesses including children (Home Office, 2000), which includes specific guidance in relation to disabled children. Measures made available through the Youth Justice and Criminal Evidence Act (1999), with the introduction of intermediaries, are specifically designed to address the barriers and enable disabled children to give evidence.
• Following any section 47 enquiries, the need for the disabled child and their family to be provided with ongoung support, should be recognised. This is especially important where disabled children have disclosed that they have been abused. The need for therapeutic services for disabled children, following such experiences is not always recognised. Emotions can show themselves in other ways, for example, self-harm or challenging behaviour.
• The needs of disabled people who have been abused as children, to be able to access therapeutic services should also be given consideration. 

For more information, see Safeguarding disabled children (Department for Education).

Assessment, support and treatment

Effective assessment should be multi-agency, child-focused and consider the unmet needs of the child, the underlying reasons or triggers for the behaviour, protective factors and strengths, and what can be done to reduce the HSB. This assessment will ensure the right level of response by services.

If the identified behaviour is not subject to prosecution (this may be the outcome in regard to learning disabled young people or where diversion therapy is offered), multi-agency assessment and planning with a view to appropriate treatment and placement remains essential as a preventive measure to both protect the young person themselves and to safeguard others.

In cases which involved the justice system, a structured needs assessment should be carried out to ensure that the correct decision is made and effective intervention pathways are identified. Some young people may need specialist input (residential educational / therapeutic).

Disabled children and the law

The Children Act 1989 (Section 17) clarified the position of disabled children as children in need and defined disability using a National Assistance Act 1948 definition as ‘a child is disabled if he is blind, deaf or dumb or suffers from mental disorder of any kind or is substantially and permanently handicapped by illness, injury or congenital deformity or such other disability as may be prescribed’. The Children Act 1989 lays down a general duty on local authorities to safeguard and promote the welfare of children in their area and so far is consistent with that duty to promote the upbringing of such children by their families by providing a range and level of services appropriate to those children’s needs.

Further information

• Safeguarding Disabled Children: Practice Guidance